MEDICARE: DR. CARA BUSSELL, PHD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1093604118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. CARA BUSSELL, PHD, LLC

Provider Business Mailing Address
First Line	:	2316 N WAHSATCH AVE # 322
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-6941
Country	:	US
Telephone Number	:	719-377-5493
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 W COLORADO AVE STE 112
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-3354
Country	:	US
Telephone Number	:	719-377-5493
Fax Number	:

Authorized Official
Title or Position	:	OWNER / CLINICAL PSYCHOLOGIST
Name	:	DR. CARA ANN BUSSELL
Credential	:	PHD
Telephone Number	:	719-377-5493

Provider Enumeration Date	:	07/02/2025
Last Update Date	:	07/02/2025

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